Thi Hai Quynh Pham
Thi Hai Quynh Pham; Anthony Worsley; Mark Lawrence; Bernie Marshall Deakin University
Australia
Economic growth has brought significant changes in the dietary patterns and lifestyles of the Vietnamese population. This has resulted in Vietnam undergoing a ˜nutrition transition. The challenge for Vietnam in combating the nutrition transition problems is to implement prevention strategies to halt the growing trend in obesity and noncommunicable diseases (NCDs), against a background of prevailing nutrient deficiency diseases. Critical to these efforts is the need for a professional workforce with sufficient public health nutrition (PHN) knowledge and skills to influence policy-making and program delivery.
Professionals who provide health and nutrition education and consulting to the public need to understand the environmental and social contexts that influence the populations health behaviours.
In turn, their perceptions of the populations health problems reflect their preparedness and readiness to advocate for better population health. The preparation of these professionals is a major task for university nutrition lecturers.
The current study aimed to investigate the awareness of health problems associated with the nutrition transition among Vietnamese health and school education professionals and university nutrition lecturers. These professional groups were selected because they play key roles in the communication of knowledge of health risks to future professionals and the broader community.
The main research aim was to establish an understanding of health and education professionals current concerns and preparedness to respond to the nutrition transition.
An online survey was conducted among 242 Vietnamese health and school education professionals, and university nutrition lecturers. Third-party introductions were used to recruit potential participants for the survey. The websites of 18 Vietnamese universities were used to contact lecturers who taught nutrition to undergraduates in education, food science and processing, medicine and health sciences (public health, nursing, dentistry).
The questionnaire content was informed by a literature review and two qualitative studies (interviews). Five main questions, each with several items were asked. Five point response scales were used.
Question A examined respondents awareness of the shifts in the undernutrition and obesity conditions in the population in recent years. In question B, respondents were asked to indicate their
asked to indicate the reasons for the growth in child obesity prevalence. Question E investigated respondents views of food marketing to children.
The responses were analysed via IBM SPSS Statistics. The respondents were divided into three occupational groups: university nutrition lecturers, health professionals (general practitioners, medical doctors, nurses, and health administrators), school education professionals (school principals and teachers). Comparisons of the responses of the three groups were tested via the Crosstabs program.
The increasing prevalence of obesity in children and adults was recognised by most respondents (96.7% and 93.4%, respectively). There were no statistically significant differences between the proportions of respondents who saw obesity as a critical health problem and those who were concerned with the seriousness of undernutrition in Vietnam (66.9% compared to 61.2% of all the respondents).
Nearly all the respondents agreed that NCDs prevalence in adults had increased (96.7%). Although 43.8% of the respondents believed that NCDs were more common in high-income population groups than low-income groups, more than half reported there had been an increase in the prevalence of NCDs among low-income population groups (54.5%). Nine out of ten respondents agreed that NCDs have become prevalent in young adults (91.3%).
Nearly half of the respondents believed that it was much easier to control underweight than to control obesity (48.8%). The same proportion held the view that the government should complete its attempts to control underweight before trying to control obesity (48.8%).
Fewer respondents saw food marketing as a cause of the increased prevalence of obesity compared to other reasons such as consumption of unhealthy food, increased prosperity (71.5% compared to 95.5% and 83.5%). The three professional groups differed in their perceptions of the influence of food marketing on population health problems. In particular, 86.0% of the health professionals believed that food marketing was responsible for the growth in child obesity, but only 71.7% of the school professionals and 65.5% of the lecturers held the same view.
Overall, although most of the professionals correctly understood the recent changes in the nutrition- related conditions in Vietnam, many had less accurate perceptions of the underlying drivers and actions needed to address these problems. The lesser awareness, especially among nutrition lecturers, of food marketing and its impacts on childrens health suggests that they may not adequately understand the drivers of the nutrition transition. Furthermore, the view expressed by half the respondents that undernutrition problems should be controlled before tackling overweight and obesity suggests they may misunderstand current Vietnamese and international public health priorities to mitigate the negative effects of the nutrition transition. Undernutrition and obesity need to be addressed together, NCDs cannot be ignored while efforts to reduce undernutrition continue.
The university nutrition lecturers did not show any greater awareness of the nutrition transition than their extramural colleagues. More experienced lecturers might be expected to have had higher levels of knowledge and perceptions of the severity of the health problems associated with the
acquire up-to-date knowledge and the absence of nutrition transition topics in university nutrition curricula.
The results suggest that greater provision of nutrition education for health and other professionals is essential, enabling them to support public health policies and programs. In the same vein, better resourcing and public health nutrition education of university nutrition lecturers is required to enable them to enhance the education of future health and education professionals.